Hai Piao Xiao (Cuttlefish Bone, Cuttlebone)

Chinese Herb Actions

Chinese Herb Dosage

• What is the typical dosage of Hai Piao Xiao?

  Roughly 6–12 g in decoction (crushed before adding), consistent with its use at 12 g in the classical formula Gu Chong Tang. For its acid-controlling action it is often ground to a fine powder and taken directly at roughly 1.5–3 g, since calcium carbonate is not well extracted by decoction. As a topical, the powder is dusted directly onto sores, discharging wounds, or bleeding.

  Source: Gu Chong Tang formula composition (Sacred Lotus, 12 g); Bensky, Materia Medica (3rd ed.); Chen & Chen, Chinese Herbal Medicine: Materia Medica. Reference only — not a prescription.

Chinese Herb Contraindications & Cautions

• Are there cautions for Hai Piao Xiao?

  Materia medica sources caution against use in yin deficiency with heat signs (as a warming, astringent substance it can aggravate heat), and note that extended or excessive use may cause constipation, consistent with its calcium-carbonate content. As a mineral/shell substance it is traditionally crushed or broken before decoction; it is best used under a qualified practitioner rather than self-prescribed, particularly for internal (non-topical) use.

  Source: Bensky, Materia Medica (3rd ed.); Chen & Chen, Chinese Herbal Medicine: Materia Medica.

Chinese Herb Toxicity & Overdose

• Low. Hai Piao Xiao (cuttlebone) is composed primarily of calcium carbonate (commonly reported above 85%) with trace proteins, peptides, and inorganic elements; a 2025 pharmacology review characterizes cuttlebone as nontoxic at the levels reported in the literature. The main documented safety consideration is not the calcium carbonate itself but trace arsenic content: a Chinese-pharmacopoeia quality study analyzing 32 Sepiae Endoconcha samples by HPLC–ICP–MS found inorganic arsenic (As(III)/As(V)) detectable in about 28% of samples, with roughly 19% exceeding food-safety limits for inorganic arsenic despite meeting the total-arsenic standard — the authors recommend a species-specific inorganic-arsenic limit rather than relying on total arsenic alone.

  Source: PMID 39778786, DOI 10.1016/j.jep.2025.119333 (cuttlebone chemistry/bioactivity review, nontoxicity characterization); PMID 32237338, DOI 10.19540/j.cnki.cjcmm.20190903.201 (arsenic speciation and limit-standard study). Reference note, not a safety guarantee.

Herb-Drug Interactions

• No clinical herb–drug interaction trials of Hai Piao Xiao itself are published. Because the substance is predominantly calcium carbonate, general calcium-carbonate/antacid pharmacology is a reasonable reference point rather than herb-specific data: a controlled study in hypothyroid patients found that daily calcium carbonate (1,200 mg elemental calcium) taken concurrently with levothyroxine significantly reduced T4 and raised TSH, via adsorption of thyroxine onto calcium carbonate at acidic pH. By the same chelation mechanism, calcium-carbonate antacids are widely documented to reduce absorption of tetracycline-class antibiotics and other pH-/chelation-sensitive drugs when taken together. (Extrapolated from general calcium-carbonate pharmacology, not a Hai Piao Xiao–specific study; flagged for practitioner confirmation — a 2+ hour separation from thyroid medication, tetracyclines, or similar drugs is a reasonable precaution.)

Western / Biomedical Research

Chinese Herb Clinical Studies & Research

Provided as research context — a summary of published biomedical study, not a therapeutic or medical claim.

• Is there modern research on Hai Piao Xiao (Os Sepiae Seu Sepiellae / Sepiae Endoconcha)?

  Yes — a 2025 pharmacology review and quality-control studies, though direct human-clinical evidence specific to Hai Piao Xiao as a TCM substance remains essentially absent. Most support is preclinical or compositional/quality-control research rather than clinical trials of oral TCM dosing.

  • Comprehensive bioactivity review (2025) — a Journal of Ethnopharmacology review of cuttlebone chemistry and ethnopharmacology (screening 165 Chinese and 279 English articles) reports documented hemostatic/anticoagulant, antiulcer and wound-repair, antibacterial and antiviral, anti-hyperphosphatemia, osteogenic (bone-regenerative), and antioxidant activities, and describes cuttlebone’s distinctive porous “wall-septa” calcium-carbonate microstructure as the basis for emerging biomedical/bone-scaffold applications. Review-level and preclinical evidence, not clinical trial data.
  • Arsenic speciation / safety-limit study — HPLC–ICP–MS analysis of 32 Sepiae Endoconcha samples found inorganic arsenic in roughly 28% of samples, with about 19% exceeding inorganic-arsenic food-safety thresholds despite compliant total-arsenic levels; proposes species-specific (organic vs. inorganic) arsenic limits. Quality-control research, not efficacy research.
  • Calcium-carbonate / levothyroxine absorption (general pharmacology, not herb-specific) — a controlled study in hypothyroid patients found concurrent calcium carbonate significantly lowered T4 and raised TSH via gastrointestinal adsorption of thyroxine; relevant to Hai Piao Xiao given its predominant calcium-carbonate composition (see drug interactions, above).

  Human clinical-trial evidence specific to Hai Piao Xiao itself is essentially absent; current support is preclinical/review-level plus compositional quality-control data.

  Sources: PMID 39778786, DOI 10.1016/j.jep.2025.119333 (cuttlebone chemistry/bioactivity review); PMID 32237338, DOI 10.19540/j.cnki.cjcmm.20190903.201 (arsenic speciation and limit-standard study); PMID 10838651 (calcium carbonate/levothyroxine absorption, general pharmacology, not herb-specific). Research context, not a therapeutic claim.

Chinese Herb Notes

• What are Hai Piao Xiao’s key combinations, and how is it different from Long Gu and Mu Li?

  Hai Piao Xiao shares the astringing, stabilizing action of Long Gu and Mu Li, but its distinguishing traditional uses are controlling stomach acid and topically healing damp, discharging sores — actions Long Gu and Mu Li do not share.

  • Long Gu / Mu Li — astringe and stabilize (essence, sweating, bleeding) and calm the Spirit/settle Liver yang; no acid-controlling or topical sore-healing use.
  • Hai Piao Xiao — astringes and stabilizes, plus controls stomach acid and dries dampness/promotes healing of external sores.

  Common combinations: with Qian Cao Gen (Rubia root, roughly 4:1) to stop uterine bleeding — both appear together in Gu Chong Tang (Zhang Xichun), alongside calcined Long Gu and Mu Li, Wu Bei Zi, Shan Zhu Yu, Huang Qi, Bai Zhu, Bai Shao, and Zong Lu Pi, for severe or prolonged uterine bleeding. With Zhe Bei Mu as the simple formula Wu Bei San for acid reflux and epigastric pain. With Long Gu for spermatorrhea and seminal emission. (Traditional formula context, not treatment advice.)

  Source: Sacred Lotus formula link (Gu Chong Tang herb list); Bensky, Materia Medica (3rd ed.); Chen & Chen, Chinese Herbal Medicine: Materia Medica.